Increased Risk of Pulmonary Embolism Among US Decedents With Sarcoidosis From 1988 to 2007

Abstract

Background: A recently published report from the United Kingdom suggested an association between sarcoidosis and pulmonary embolism (PE). We sought to examine whether this association was present among US decedents with sarcoidosis. Methods: We used data from the National Center for Health Statistics to investigate the association between sarcoidosis and PE among US decedents from 1988 to 2007. Results: From 1988 to 2007, there were 46,450,489 deaths in the United States and 23,679 decedents with sarcoidosis mentioned on their death certifi cates. Among these, 602 (2.54%) had PE mentioned on their death certifi cates, compared with only 1.13% of the background population ( P , .0001 for comparison). The association between sarcoidosis and PE was signifi cant regardless of gender (OR, 2.07; 95% CI, 1.80-2.39; P , .0001 for men and OR, 1.76; 95% CI, 1.59-1.96; P Յ .0001 for women) or race (OR, 1.57; 95% CI, 1.41-1.76; P , .0001 for blacks and OR, 1.87; 95% CI, 1.63-2.14; P , .0001 for whites). Among decedents with sarcoidosis, there was no difference in risk of PE between men and women (2.30% vs 2.54%, x 2 5 1.32, P 5 .25) or between blacks and whites (2.60% vs 2.23%, x 2 5 3.09, P 5 .08). The association between sarcoidosis and PE held regardless of age. Conclusions: Using death certifi cate data from 1988 to 2007, we detected an association between sarcoidosis and PE regardless of gender, race, or age. Further investigation is needed to decipher the mechanisms of this apparent association.

Management of end-stage sarcoidosis: pulmonary hypertension and lung transplantation

“…Indeed, the prevalence of OSA in sarcoidosis has been reported to be 17%, which is much higher than what might be expected in a healthy patient population [32]. Finally, while chronic thromboembolic disease should be considered as a potential cause of or contributor to PH, acute pulmonary embolism might also warrant exclusion in the context of new acute or subacute shortness of breaths and/or signs of increasing right-sided heart failure [33,34].…”

“…In the largest non-transplant cohort of 479 sarcoidosis patients followed f7 yrs, the factors influencing the development of respiratory failure included both radiographic findings of fibrosis and a vital capacity ,2.5 L. A vital capacity of ,1.5 L was present in all patients who subsequently developed end-stage disease [58]. The ISHLT listing guidelines are primarily based on studies examining the United Network of Organ Sharing (UNOS) database as well as a much smaller study of 43 patients from a single transplant centre [33,36,59]. Univariate analysis from this latter study demonstrated that resting hypoxaemia, PH (mPAP o35 mmHg), cardiac index f2 L?min -1…”

Atrial Fibrillation and Ventricular Tachycardia in a Patient with Cardiac Sarcoidosis

“…1 Patients with sarcoidosis are at higher risk for pulmonary embolism, raising the concern that systemic inflammation may increase the risk of hypercoagulability in this population. 17 Medications such as β-blockers, calcium channel blockers, sotalol, dofetilide, and amiodarone can also be used in the course of treatment, though there are no comparative data to guide antiarrhythmic drug selection.…”

Pulmonary Hypertension in the Course of Diffuse Parenchymal Lung Diseases—State of Art and Future Considerations

“…Swigris et al found that PE as the cause of death was significantly more frequent in sarcoidosis patients comparing to others (2.54% and 1.13% respectively) [50]. Vorselaars et al found PE in 6.2% of the patients with severe sarcoidosis requiring immunosuppressive therapy other than corticosteroids [51].…”